Older Adults Need More Focus on Vision

Many people don’t get screened when eye problems are not obvious

Many adults 50 and older aren’t getting screened for vision problems regularly, which means that eye diseases may not be diagnosed and treated early enough to prevent vision loss, according to the findings of a new University of Michigan/AARP poll.

The survey found that 18 percent of older people haven’t seen an optometrist or ophthalmologist in three years or more or were not sure when they had their last eye exam. The study was part of the National Poll on Healthy Aging, sponsored by AARP and Michigan Medicine, the University of Michigan’s academic medical center.

More than 40 percent of those who had not seen an eye doctor in three or more years said they hadn’t had their eyes checked because they weren’t having any vision problems. Others said they were dissuaded from getting an exam by the cost or that they just hadn’t gotten around to it.

“Vision loss affects an older adult’s overall health, risk of falling, social interactions and quality of life,” says Alison Bryant, senior vice president of research for AARP. “But not everyone has coverage for routine vision care and eyeglasses.”

The survey also revealed that many primary care doctors aren’t routinely asking their patients about their vision: 58 percent of those who had regular medical checkups reported that their primary care physician or other providers hadn’t asked about their eyes. Respondents who had a low household income, a history of eye disease or diabetes were more likely to say they were asked about their vision. Still, 2 out of 5 people with diabetes who had regular primary care checkups said their doctor didn’t ask about their vision.

There are a range of eye conditions related to diabetes, including diabetic retinopathy and diabetic macular edema. The Centers for Disease Control and Prevention (CDC) recommends that people with diabetes have a comprehensive eye exam every year and those with a high risk of glaucoma every two years.

Doctors point to the dangers of waiting until there is vision loss to have an exam. Many eye diseases may not offer any obvious early-warning signs, but they can be diagnosed during a comprehensive exam and followed up with treatment that might prevent further damage.

The most prevalent eye problems are cataracts, glaucoma, macular degeneration and diabetes-related eye disease. About a quarter of the poll respondents said they’d been diagnosed with at least one of those ailments.

“We know that many eye diseases become more common with age, but that most vision loss is preventable or treatable,” says Joshua Ehrlich, an assistant professor of ophthalmology and visual sciences at the University of Michigan Kellogg Eye Center. “For those with risk factors like diabetes and certain other medical conditions or a family history of eye disease, receiving regular eye care could be key to avoiding vision loss.”

That vision isn’t routinely brought up in primary care visits is, in part, due to other medical issues taking priority, says Preeti Malani, director of the poll and a geriatrics specialist. “Older adults often have a long list of health concerns to discuss with their primary care provider. Difficulties with vision might not always come to mind.”

But primary care providers are important partners with eye care specialists in advising high-risk adults about when to see an eye doctor, the researchers say. Their discussing vision problems with patients could remind them to have regular screenings and keep eye health a priority. A full report of the findings and methodology is available at healthyagingpoll.org, along with past National Poll on Healthy Aging reports.

The poll results are based on responses from 2,013 adults between the ages of 50 and 80. The margin of error is plus or minus 1 to 2 percentage points for all question frequencies and is higher among subgroups.

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